Factors Associated with Family Belongingness in Children Under Legally Required Health Care.

Introduction: It is known that family dysfunctions increase the risk of abuse, neglect and delinquency in children. On the other hand, family belonging was shown as one of the protective factors against these types of risks. In this study, it was aimed to investigate the relationship between family belonging and various risk factors for children and their families who are being treated in a mental health clinic with the decision of health measure. Method: The study group consisted of 57 adolescents who were treated with a health measure decision, and the control group consisted of 42 adolescents who were treated in the same clinic without any health measure, both groups were over the age of 14. The Parenting Style Scale and The Family Belonging Scale were applied to the participants who took part in the study on a voluntary basis. Data in the sociodemographic information form were updated with the help of parents. Results: Children with health measure decisions had higher rates of grade repetition, exposure to a negative life event, domestic physical and verbal violence, living in a fragmented family system, presence of mental illness in the mother, and a history of delinquency in family members compared to children in the control group. It was found that children's participation in social activities, and the education and income levels of the parents were lower. Additionally, authoritarian and negligent parenting styles were more pronounced and family belonging was lower in the same group. In the regression analysis, it was revealed that the family belonging of children who had been followed up with a health measure desicion, increases with the participation in social activities and decreases with physical violence. Conclusion: Our study supported that in studies targeting children at risk or in need of protection, family-oriented interventions are protective, preventive and curative.

The impact of COVID-19 on food management in households of an emerging economy.

The COVID-19 pandemic has affected how households buy, prepare and consume food, with resultant impacts on food waste generated. These impacts have not yet been properly understood, especially in the context of developing countries. Better understanding of the impacts of COVID-19 on food management behavior of households can aid in the design of policy interventions to reduce the amounts of wasted food during disastrous events. This becomes particularly important in light of the likely pro-longed effect held by the pandemic on household lifestyles in the future. This study has segmented households in Turkey, a rapidly emerging economy, on the basis of the effects imposed by COVID-19 on their food management behavior. A two-step clustering analysis has been conducted on the factor scores of planned shopping and cooking skills. Three segments were identified: careless planners and cooks, resourceful planners and cooks and careless planners and resourceful cooks. The segments were further described using health orientation, price consciousness, environmental concern, food waste disposal routines and self-perception of the amount of food waste variables. The first and the smallest segment, careless planners and cooks, is characterized by low levels of planned shopping and cooking skills, with resultant significant wastage. The largest segment of resourceful planners and cooks demonstrates excellent planned shopping and cooking skills, with resultant small wastage. The segment of careless planners and resourceful cooks showcases excellent cooking skills, but poor skills of planned shopping. The study provides first known evidence to understand how Turkish households differ on the grounds of their food management behavior in the time of the pandemic, thus laying a foundation for future segmentation studies in Turkey and beyond.

What influences consumer food waste behavior in restaurants? An application of the extended theory of planned behavior.

Consumer food waste during the consumption stage is usually generated in different settings (at home or out-of-home). Consumer food waste behavior has been the focus of substantial investigation in the search for the mitigation of food waste in households. However, researchers have not treated consumer food waste behavior in restaurants in much detail. This study aims to test an extended Theory of Planned Behavior by including price consciousness and food taste to understand the antecedents of food waste behavior in restaurants. An online survey provided quantitative data from 329 participants. The results showed that (1) the extended TPB model is useful in predicting consumer food waste behavior in restaurants with an improved variance in food waste behavior from 13% to 15%; (2) intention to reduce food waste and perceived behavioral control had a significant negative effect on food waste behavior; (3) food taste exerted a significant positive effect on food waste behavior; (4) attitudes towards food waste, perceived behavioral control and price consciousness positively affected intention to reduce food waste. The current study represents a further step towards understanding consumer food waste behavior in restaurants.

Ten-Year Experience Outcomes of a Day Treatment for Children and Adolescents with Psychiatric Disorders.

INTRODUCTION: It was aimed to evaluate the efficacy of a day treatment clinic in Turkey and which has been serving for ten years for children and adolescents with psychiatric disorders. METHODS: 262 patients who completed day treatment within ten years were tested at intake and discharge. The patients' functioning was assessed using the Children's Global Assesment Scale (CGAS), Clinical Global Impression Scale (CGIS), state-trait anxiety inventory for children, depression rating scale for children, Coopersmith self-esteem inventory for children. Pre/post treatment comparisons were made on same variables. RESULTS: Statistical analyses showed that, improvement was maintained on all measures. The high CGAS scores at discharge were showed well-being and good functioning of patients. The CGIS scores varied from moderately disturbed (4.83±0.88) to much improved (2.55±0.93) demonstrated that treatment responses showed improvement. Wilcoxon T tests showed that patients were significantly more anxious and depressive at intake and had more problems in self esteem. State-trait anxiety inventory for children and depression rating scale for children scores decreased and Coopersmith self-esteem inventory for children scores improved with day treatment. CONCLUSION: This study points that as results of ten-year experience, day treatment approach seems effective and therefore to be the treatment of choice for treating children and adolescents with psychiatric disorders. It also shows the necessity of a treatment that combines multiple modalities like day treatment and day treatment must be more generalize for these patient population.

Non-suicidal self-injury behaviors` features and relationship with adolescents` daily life activities and mental status.

Çimen ID, Coskun A, Etiler N. Non-suicidal self-injury behaviors` features and relationship with adolescents` daily life activities and mental status. Turk J Pediatr 2017; 59: 113-121. This study investigated, characteristics of the non-suicidal self-injury (NSSI) behaviors and behaviors` relationship with the sociodemographic characteristics, psychological problems and other features like daily life activities, between the ages of 12 and 17 years in the central district Izmit of Kocaeli; 555 students whose data included to study received a sociodemographic questionnaire (SQ) and Youth Self-Report (YSR). Students, who reported that they had NSSI, were additionally evaluated with the Inventory of Statements About Self-injury (ISAS). We found out a significant correlation between NSSI and the psychological problems, habits with addiction-forming potential, some daily life activities and making friends with negative characteristics. We concluded that prevention of the risk factors related to NSSI might be effective to avoid the development of this behavior. And diagnosing the behavior in the onset, might provide more effective and long-lasting results and enable the adolescent to get over this risky period with minimal harm.

Frequency and correlates of psychiatric disorders in early childhood: a study of population and clinical samples in Turkey.

Behavioral and emotional problems experienced in early childhood may have a major impact on the development and functioning of a child, leading to a number of psychiatric problems at a later age. The purpose of this study was to determine the incidence of psychiatric disorders in 3-5-year-old children presenting to the Outpatients Department and in the general population, and the relationship between psychiatric disorders and the sociodemographic characteristics of the children. This was a cross-sectional study carried out in Kocaeli, Turkey. Data were collected from two different groups, one representing the general population and the other based on children presenting to the Pediatric Psychiatry Outpatients Department at Kocaeli University Faculty of Medicine. Of the 309 children in the study, 187 (60.5%) were boys and 122 (39.5%) were girls. Children aged 3-5 years (n = 81) were assessed by clinical examination. The mean age of the children was 3.94 +/- 0.81 years. No significant difference was observed between the groups in terms of parents' age groups, presence of consanguineous marriage, family structure, and siblings. The mothers were assessed in terms of regular visits to their physicians, major medical conditions, medication use, alcohol or tobacco consumption, and stress factors during their pregnancies. No significant difference was found between the study samples. The presence of a medical problem after birth was significantly more common in the clinical sample. Of the children in the clinical sample, 79% had at least one psychiatric problem, while the ratio for the general population sample was 41.7%.

The volumetric differences of the fronto-temporal region in young offspring of schizophrenic patients.

The aim of this study is to examine the volumetric differences of the fronto-temporal region in the offspring of schizophrenic patients in comparison to normal. Twenty-six offspring of chronic schizophrenic patients aged between 8 and 15 years and 23 control children were matched with respect to cranial MRI. Chronic schizophrenic patients were reevaluated with SCID-I to confirm their diagnosis. Parents of children in the control group completed SCL-90-R and were evaluated by clinical interview to exclude any psychotic disorder. The diagnoses of psychiatric disorders in all of the children were established by DSM-IV-based clinical interviews with children and parents. They underwent IQ evaluation by WISC-R and evaluated with cranial MRI. Hippocampus, thalamus, amygdala, corpus callosum, frontal, and temporal lobe volumes were measured and compared by using MANCOVA. After covarying whole brain volume, age and gender, statistically significant decrease in the measurements of corpus callosum and hippocampi, and a non-significant trend toward smaller temporal lobes were observed in the high-risk children. The structure of hippocampal formation and corpus callosum were impaired in the children of the schizophrenic patients which suggests a neurodevelopmental abnormality in subjects with genetic high risk for schizophrenia.

Validity and reliability of Pediatric Quality of Life Inventory for 2- to 4-year-old and 5- to 7-year-old Turkish children.

OBJECTIVE: In this study, we attempted to examine the reliability and validity of the Pediatric Quality of Life Inventory (PedsQL) 4.0) for 2- to 4-year-old and 5- to 7-year-old Turkish children. METHOD: Parents of 223 children in the 2- to 4-year-old age group and 198 children in the 5- to 7-year-old age group and their parents were enrolled in the study. Children were grouped as healthy, those with acute health conditions, and those with chronic health conditions. RESULTS: Internal consistency reliability alpha coefficients (Cronbach's coefficient alpha) of the PedsQL 4.0's total scale score for the parent proxy reports of 2- to 4-year-old children and 5- to 7-year-old age groups and for the child' s self-report of the 5- to 7-year-old age group were 0.85, 0.86, and 0.80, respectively. Most subscale scores were acceptable for group comparisons. For all items in the child self-report and parent proxy report, item internal consistency was found to be more than 0, 40. Children with chronic health conditions scored less than healthy children and the children with acute health conditions in parent proxy reports. However, in the child self-reports of the 5- to 7-year-old group, there was no significant statistical difference in the scores between the groups. Generally, there was a low-medium inverse correlation between the total scale scores (and most subscale scores) and the indicators of morbidity and illness burden. The correlation between the child self-report and the parent proxy reports were significant direct but low correlations. No significant difference was observed in subscale scores between genders except in the school functioning scores in parent reports of healthy children 2-4 years of age and the acute health condition group of 5-7 years of age. School functioning scores of boys were significantly lower than for girls. CONCLUSION: The parent proxy reports of the Turkish translation of the PedsQL 4.0 may be used in research for group comparisons for 2- to 7-year-old Turkish children.

[The validity and reliability of the Turkish Pediatric Quality of Life Inventory for children 13-18 years old]. / Cocuklar Için Yasam Kalitesi Olçeginin 13-18 Yas Ergen Formunun Geçerlik ve Güvenilirligi.

OBJECTIVE: The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument that measures health related quality of life, and investigates the physical and psychosocial functioning, unrelated to health, of children 2-18 years old. In this study, the objective was to evaluate the validity and reliability of the Turkish PedsQL in adolescents 13-18 years old. METHOD: The study included 230 adolescents and 230 parents. The subjects were separated into 3 groups: 1. Healthy; 2. Has an acute disease; 3. Has a chronic disease. The reliability and the validity of PedsQL were computed. RESULTS: The internal consistency of the scale (Cronbach's alpha coefficient) was 0.82 for the child self-report and 0.87 for the parent proxy report. The PedsQL scores of both the child self-report and parent proxy report showed a statistically significant low to medium level of inversely proportional correlation with many indicators of morbidity and illness burden. There was a statistically significant and direct proportional correlation between the child self-report and parent proxy report scores. CONCLUSION: The PedsQL is valid and reliable for evaluating the quality of life of Turkish adolescents 13-18 years old.

[The reliability and validity of the children's negative cognitive errors questionnaire]. / Cocukluktaki Olumsuz Düsünceleri Degerlendirme Olçegi Geçerlik-Güvenilirlik Calismasi.

OBJECTIVE: The Children's Negative Cognitive Errors Questionnaire (CNCEQ) is a self-report scale measuring negative cognitive errors in children. The aim of this study was to examine its reliability and validity, and to obtain its norms for Turkish children. METHOD: The study was carried out at 3 public schools representing 3 different socioeconomic statuses. The sample of 538 children was selected randomly among third-eighth grade elementary school students. The students were evaluated by the CNCEQ, Children Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Coopersmith Self-Esteem Inventory (SEI). For test-retest reliability, the CNCEQ was readministered to the students 7 days after its first administration. RESULTS: In the reliability analysis, the Cronbach's alpha coefficient was calculated as 0.82 and 0.79. Test-retest reliability of the total score was 0.87. In comparing the CNCEQ to CDI, SAIC, TAIC, and SEI, correlations were r = 0.77, r = 0.57, r = 0.50, and r = -0.65, respectively (P < 0.001). Construct validity factors had eiganvalues > 1. These factors were related to catastrophizing, personalizing, and selective abstraction. CONCLUSION: The Turkish version of the CNCEQ has appropriate reliability and validity for assessing negative cognitive errors in Turkish children; however, additional reliability and validity studies should include patient groups with specific disorders.

Evaluation of the effect of methylphenidate by computed tomography, electroencephalography, neuropsychological tests, and clinical symptoms in children with attention-deficit/hyperactivity disorder: A prospective cohort study.

BACKGROUND: Stimulant drugs are the most commonly used treatments for attention-deficit/hyperactivity disorder (ADHD), although the mechanism of action of these drugs is still not entirely understood. OBJECTIVE: The aim of this study was to investigate the effects of the psychostimulant drug methylphenidate (MPH) on regional cerebral blood flow (rCBF), electrical activity of the brain, and clinical symptoms in children with ADHD using single-photon emission computed tomography (SPECT), electroencephalography (EEG), and neuropsychological tests. METHODS: In this prospective cohort study, pediatric outpatients received MPH for 3 months at a mean dose of 1 mg/kg · d (range, 0.5-1.5 mg/kg · d). They were then administered the Wechsler Intelligence Scale for Children-Revised, the Bender Visual-Motor Gestalt Test (BGT), EEG, and SPECT of the brain. The parents and/or teacher of each child were asked to complete the Conners' Parent Rating Scale (CPRS), the Conners' Teacher Rating Scale (CTRS), and the Turgay Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). All of the evaluations were performed at baseline and after 3 months of MPH treatment. Each child underwent a Stroop test as an activation method 15 minutes before the SPECT procedure. RESULTS: Sixty patients were assessed for inclusion. Twenty-one children (18 boys [85.7%], 3 girls [14.3%]; mean [SD] age, 9.7 [1.7] years; range, 8-13 years) with a diagnosis of ADHD were included in and completed the study. Mean (SD) BGT scores before MPH treatment compared with after MPH treatment were significantly decreased (9.8 [4.2] vs 6.3 [3.4]; Z = -3.27; P = 0.001). After treatment with MPH, the visual SPECT results suggested that low rCBF was normalized in the right frontotemporal areas in 10 children with ADHD. After treatment, 12 patients (57.1%) had no change in EEG activity, 5 (23.8%) had improvement, and 4 (19.0%) had worsening activity. Patients who had improvement or no worsening on EEG after MPH treatment were associated with significant improvement after MPH treatment compared with before treatment in mean (SD) CTRS scores (25.9 [14.3] vs 35.0 [14.4]; P = 0.003), teachers' T-DSM-IV-S total score (25.1 [14.2] vs 38.4 [18.7]; P = 0.005), and CPRS scores (mothers scores: 29.7 [16.6] vs 42.6 [17.2], P = 0.002; fathers' scores: 29.4 [16.8] vs 41.9 [23.7], P = 0.004). No significant difference was found in these scores in the patients whose EEG findings showed deterioration after MPH treatment. The quantitative values for SPECT observed before treatment compared with those observed after 3 months of MPH treatment were not found to be significantly different in any areas of the brain. CONCLUSIONS: MPH use over 3 months was associated with improvement from baseline in visual-motor function and behavioral disorders in these children and adolescents with ADHD. However, no significant difference in rCBF or electrical activity in the brain was observed in this small study.

Psychiatric approach in the treatment of reflex sympathetic dystrophy in an adolescent girl: a case report.

Reflex sympathetic dystrophy (RSD) is an unusual diagnosis in the pediatric age group. It is a syndrome characterized by pain in one or more extremities with a significant morbidity in childhood. Patients with RSD have frequently undergone many unnecessary investigations such that the diagnosis and treatment may be considerably delayed. The pathophysiology remains unclear; however, a number of psychological problems were frequently suggested to play a role in this disorder. We describe a 13-year-old girl diagnosed as pediatric RSD who was admitted to a child and adolescent psychiatry unit with a history of severe pain in the right hand, increasing disability and symptoms of nervousness and withdrawal from social activities. In this report, we discuss psychogenic factors underlying the disorder of an adolescent girl and psychiatric approach as a part of a multimodal treatment of pediatric RSD.

[The symptoms of PTSD, depression and anxiety in adolescent students three and a half years after the Marmara earthquake]. / Marmara Depreminden Uç Buçuk Yil Sonra Ergenlerde TSSB, Depresyon ve Anksiyete Belirtileri.

OBJECTIVE: To screen the symptoms of posttraumatic stress disorder (PTSD), depression and anxiety in adolescent students three and a half years after the Marmara earthquake in Turkey. METHOD: Overall 334 students were selected from secondary schools located within Kocaeli province in Turkey, three and a half year after a severe earthquake. They were chosen to participate in this cross-sectional study by simple random sampling. The students were evaluated by the Child Posttraumatic Stress Reaction Index (CPTSD-RI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI). Additionally, an information form was filled out by the students. RESULTS: Of the 334 students we found that 1.8% had very severe, 20.4% had severe, 38.3% had moderate and 30.2% had mild symptoms of PTSD and that 22.2% had probable PTSD and 30.8% had probable depression diagnoses. The frequency and intensity of re-experiencing and hyperarousal symptoms were considerably high on CPTSD-RI. The mean grades of anxiety measures were higher than that of the normal population. A significant correlation was determined between PTSD, depression and anxiety. CONCLUSION: The symptoms of PTSD depression and anxiety may continue for years after natural disasters. Hence, prevention studies and the screening of children and adolescents after disasters are important for the mental health of the community.

Acrocyanosis as a side effect of tricyclic antidepressants: a case report.

Acrocyanosis is probably the most unusual side effect of tricyclic antidepressant drugs. In this paper, we report a 10-year-old boy with primary enuresis nocturna and attention deficit hyperactivity disorder who developed two episodes of acrocyanosis, the first of which was after imipramine treatment and the second after desipramine usage. We also review the possible pathogenesis of acrocyanosis. We suggest that physicians should be aware of this rare side effect of tricyclic antidepressants.